I am post menopausal and had a unilateral right side mastectomy last February with 2 stage reconstruction ( saline expander inserted at time of surgery and subsequently exchanged for permanent silicone implant) completed in July.
In Jan. 2022, after a “ normal “ mammo and ultrasound in October 2021 I requested an MRI due to a persistent symptom.

BOOM! I was diagnosed with 2 foci ( 2 tumors) unilateral IDC , stage II ( 2 sentinel nodes positive - 5 above those negative) grade II, both ER/PR + HER2- .

The Oncotype indicated that chemo would NOT be beneficial in my case. I am in month 10 of an Aromatase Inhibitor… also known as “hormone therapy “ which is prescribed to limit estrogen production in post menopausal women. I will be taking this for 5-7 years. Similar estrogen limiting therapy is prescribed for pre menopausal women who need to also shut down ovarian estrogen production.

The ONCOTYPE will inform your health team regarding need for ( benefit of) receiving chemo. Since 2015 70% of women with ER/PR + HER2- breast cancer diagnosis have been spared chemo. It’s possible that a non definitive PR + may exclude the option of the ONCOTYPING ( I don’t know).

That said, I understand that if you begin hormone therapy before typing an ONCOTYPE cannot be applied to the biopsy or surgical tissue; it will have been compromised.

A new trial , TAILOR RT is now looking at the need for ( benefit of) radiation therapy. I believe it’s designed to include 1-3 node positive status. It’s still in trial and not definitive. Worth reading about.

My breast surgeons did not recommend radiation but the radiation oncologist did. That’s why I researched the benefit/risk information and found the TAILOR RT trial . My IDC profile fit that trial parameter. One arm of trial was AI alone ( hormone therapy) the other arm was AI plus standard radiation. I opted out of radiation.

Going forward I will get a yearly mammo for healthy breast alternating with a yearly MRI (for both sides ) at 6 mos. Intervals.

It’s a huge learning curve and I am sorry that you have to go through this challenging journey. For me, information is a huge plus. I hope this information has been helpful to you.

Last week I had my annual MRI the same week as my surgery last year. I am ONE YEAR CANCER FREE!

Blessings in the path. 🌸